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M. Erkam SENCAR1 Erman ÇAKAL2
1 Doç. Dr., Sağlık Bilimleri Üniversitesi, Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Endokrinoloji ve Metabolizma Hastalıkları Kliniği, erkamsencar@gmail.com
2 Prof. Dr., Sağlık Bilimleri Üniversitesi, Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Endokrinoloji ve Metabolizma Hastalıkları Kliniği, ermancakal@hotmail.com
İNSÜLİN VE YAĞ DOKU İLİŞKİSİ
Yağ doku enerji dengesinin sağlanması ve substrat metabolizmasının dü- zenlenmesinde kritik rolleri olan bir yapıdır. Son yıllarda yapılan çalışmalar yağ dokunun sadece trigliserid depolayan inert bir yapı olmadığını enerji meta- bolizmasında önemli rolleri olan dinamik bir organ olduğunu göstermiştir (1).
Yağ doku, enerji dengesinin sürdürebilir olması için adipositlerin hipertrofiye
uğramasıyla (lipogenez) ve adiposit kök hücrelerin diferansiyasyonu (adipoge-
nez) yoluyla genişleyebilmekte, lipid depolama kapasitesini arttırabilmektedir
(2). İnsülinin her iki süreç üzerine de stimüle edici etkisi olduğu bilinmektedir
(2). Yapılan çalışmalar insülin ve insülin reseptörünün hem adiposit kök hücre
diferansiyasyonunda hem de embriyogenezden itibaren yağ doku gelişiminde
çok önemli rolleri olduğunu göstermiştir (3). Bunun dışında yağ doku endok-
rin ve parakrin fonksiyonları olan ve birçok metabolik olayda ve sinyal yolak-
larında rol alan ve adipokin olarak adlandırılan peptid yapıdaki moleküllerin
sentezinden ve salınımından sorumludur. Adipokinlerin, yağ ve karbonhidrat
metabolizmasında, immün sistemde, inflamasyonda, koagülasyonda, steroid
metabolizmasında, kan basıncı dengesinde, açlık-tokluk sinyal yolaklarında
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